Saturday, January 31, 2009

Clarity

The resiliency of the human mind is astounding to me. Specifically, I was thinking how laughable it is that after three miscarriages it took me precisely 2 weeks out of the first trimester to settle into the idea that my body functions perfectly and that there would be no reason to ever think that something less than perfect would be created in my womb. Seriously? Two weeks? Please remember ...it was not so long ago when I was turning pomegranate soap into blood. You would think that I would expect anything BUT perfection, right?

I have to say that I'm feeling immensely better about the entire situation after a couple of days worth of space and several prolonged conversations with the docs I surround myself with. I also called the MFM and asked his opinion about the difference in due date and what that implications it would have on the test results. He says that if the dates are truly off that much the test will easily correct out to normal. He still wants the Level II ultrasound (which I'm totally good with) to confirm the dates and says we'll go from there. I tried to weasel my way into an earlier appointment - but he's going out of town. I could see his partner ...but ..umm...I'm really partial to this guy so ...we'll wait until February 10th. I've had several really interesting conversations with both my friend/OB and other docs regarding how the wrong date was reported. The OB/friend swears she doesn't know ...that the correct date is in my chart and thinks it was a nursing error. A lot of the other docs think it was the OBs error and made several comments such as "they don't actually teach us to listen to patients in med school." We'll see. I guess it really changes nothing in the end. But I'd like to think that my friend that is my OB would listen to me. No?

So now we wait. Consciously, I'm totally at peace right now. Subconsciously I must not be because I've had MFM appointment/Downs baby dreams every single night. I'll take the conscious part for now and work on the rest later.

Thursday, January 29, 2009

Confusion

Thank you for the wonderful comments and emails ...yesterday was not a good day. In all honesty, I don't have an actual memory of writing that post or hitting publish. I'm sure it was during the point in time during the day that I was hysterical. I'm still worried today - but much more rational.

They called me at work to give me the results. The girls pulled me out of a room during a patient visit ..I picked up the phone thinking it was a doc that I had put a call in to...and heard this, "Hi Shauna this is Nurse Blah blah with OB/friend? Hon ..your quad screen is positive for Downs so we're cancelling your ultrasound here and sending you over to the perinatologist for a level II ultrasound and amnio." I honestly don't remember anything in the conversation after that.

Sometimes ...I think life provides us these lessons for a reason. I am frequently in the position to tell people awful things about their health or the health of a loved one. Daily. And while I have always considered myself to be extremely sensitive about the whole process and always schedule a follow-up 2 or 3 days later because I know they aren't going to process much after, "You have MS." or "You have brain cancer." or "Your wife has Alzheimer's disease." - I've never experienced the complete shut down that I did after that phone call.

I actually had to call them back to get the details again. Like..Umm....do I make the appointment with the specialist or were they going to? (they did). What is the actual risk ratio of the labs? (1:480, age adjusted to 1:148). What did they report as my due date on the requisition form? (A day 9 days prior to what I know my due date to be ...because ..please. I charted the day, time, and minute the OPK was positive and POAS obsessively 5 times a day until it turned positive). How much will a week or so difference in due date change the results? (a lot).

I really, really didn't want to have this test done. I don't believe in it because of this exact crap. It has a notoriously high false positive rate - but even then - it isn't a diagnostic test. It's a screen that gives you a relative risk. In my case? It increased the risk of this baby having Downs from 0.1% to 0.6%. Either way, there is still greater than a 99% chance that the baby does NOT have Downs syndrome. No matter how much additional testing tells us that the baby is fine - I will not feel comfortable until I actually deliver and there are no tell tale signs. I let the OB convince me because if the result is ..like...spina bifida ..they can do in utero surgery which can drastically alter the quality of the baby's life. I would never have the test done again in the future though.

So ..while the logical part of my brain is okay and figures..hey ..we get an awesome ultrasound out of the deal ...the emotional part of my brain is still mostly devastated. First because ...that would be incredibly sad. For our lives ...for the baby ...for the golden child ...it would change things in ways that I don't want to be changed. Secondly? I hate that I couldn't handle the phone call yesterday. I used to find myself to be incredibly strong and able to deal with just about anything. Over the past few years I've somehow turned into someone that can be knocked over by a leaf. I'm not sure when or why that happened. And third? I am very, very not proud of my immediate reaction. It was not a "I don't want to deal with this" type of reaction. It was a "I can't deal with it" reaction and I hate that. My mom has a brother that is severely, severely disabled with cerebral palsy and I have seen both her and my grandma dedicate the majority of their lives to his care. My grandma is 87 years old and still transfers him from his wheelchair to the toilet and back to bed. 87. It was honestly one of the first images that came to me when they told me the screen was positive.

They always say that we see people's truest colors in moments of crisis. I don't like what I saw in myself yesterday.

Wednesday, January 28, 2009

Quad Screen

Positive for Downs. Appointment scheduled with MFM for 4d ultrasound and amnio.

Not good news for the anxiety queen.

No other words.

Monday, January 26, 2009

4 month check-up

Sometimes, it is really, really nice to work in health care. I waited 0.5 seconds for my OB appointment today - as in they took me straight back from the desk. I'm down another 3 pounds - which is awesome considering that I've been eating like someone that's been on survivor for 8 seasons without a break and was just introduced to a buffet line. Cripes. The hunger is crazy. I made a 2 scrambled egg and cheese bagel sandwich yesterday and could easily have consumed 3 of them without blinking if I had let myself. Anyway. BP was great. Labs were fine. Heart rate still 164. I told her my theory about water pica. She told me um...no. Probably still building up blood volume and I'm fine. Keep drinking. Work less. Max 10 hours/day 60 per week for now and we'll work on restricting down farther at the next appointment. She's all about a Vbac if the baby is a normal size and not a moose like the golden child. 3D anatomy scan scheduled for 2 weeks from now. Against my better judgment, I did the quad screen and CF screen. We'll see what kind of anxiety that sets me up for in the next week. In and out including the blood draw in 22 minutes. Not too shabby.

Talking about delivery options at 17 weeks? It's so weird to feel ....normal.

Sunday, January 25, 2009

Crying It Out

Cocker Spaniel Style

We have a red Cocker Spaniel that is 2 years old. She was a consolation prize for me (after the first miscarriage) and for the golden child who desperately didn't want to move into this house. She is overly loved and very spoiled. Incredibly well behaved. She rings a bell to go outside, doesn't bark, and is cuddly and playful. She has Monk wrapped. Tightly. When we first brought her home and put her in crate at night for bedtime, she howled for hours and never really stopped. At some point, I came downstairs to find Monk sleeping on the floor in the kitchen with a few fingers through her crate. Crazy. At some point, he gave up and put her in our bed - which I strenuously objected to. Bedtime is easily her favorite time of the day. She has a whole routine which involves flopping herself on her back between us and wagging her tail while alternating her gaze between the two of us and waiting for the affection she knows is coming. It's rather endearing - but I still don't want her in our bed. Monk feels like he can't sleep without her there.

Fast forward to me being pregnant and refusing to have sleep interrupted by a dog in the last precious months before I won't sleep for months compounded by the fact that I will likely have the baby in bed at least to nurse and won't let a dog be there ....and well ....we have an impasse. So anyway. The cocker got shifted to sleep with the golden child ...and by her behavior, you would think she was shipped off to the fiery pits of hell. She did okay the first few nights but you could sense her anxiety building every night as it got to be bedtime. Last night (because we're so exciting) we were all headed to bed at the same time. The golden child started to herd the cocker upstairs and the cocker started going psycho - running 100 mph around the house so she couldn't be caught. We all found it very amusing. Finally got her upstairs ...we're all in our respective places, and the golden child got up to pee or something and we heard the dog run downstairs at mach speed and then run back up and down again frantically looking for us. Monk opened the door to our bedroom a crack and her 15 pound self came bounding into the room as though she had just been tortured by pirates for hours on end. Jumped in the bed ..ran around it 40 mph and then promptly buried herself under the covers and started shaking. Ha! No way we could see her there. Under the covers and all. Monk fished her out - carried her back to the golden child, set her on the bed and she came running back into our room faster than he could even turn around. This time she curled into me and started whimpering. It would have been pathetic if I wasn't laughing so hard. Four tries later and he finally managed to close her in with her torturer.

This morning? She was crying outside our door so Monk let her in ...she came and curled into my neck and was whimpering like a toddler that has hyperventilated from crying for so long. I looked at Monk ...he had tears in his eyes.

I sense bad things coming for when the one that is crying is ...you know....actually human.

Saturday, January 24, 2009

To blog or not to blog

So ...I'm thinking that maybe I have pica. The water thing is getting a little silly. I had pica when I was pregnant with the golden child, and thankfully, I craved ice and not ..like ...cigarette ashes or dirt or anything. To say that I craved ice is an understatement. I would drive 35 minutes to a specific hospital and go to the fourth floor and steal ice out of the ice machine in massive cups because ...well ...clearly they had the best ice in town. I would chew ice nearly all day long ...but more than that was how much I thought about ice. I should preface this by saying that I DID finally call and get my own lab results because I never got them ...and my blood sugar after the glucose tolerance test was 104. So ...I'm not thinking it's a blood sugar issue. I realized today during a lull between patients when I found myself fantasizing about different types of bottled water and where I would go to get the coldest (Fiji vs. Smart Water vs. the ice cold Brita pitcher in my fridge - Fiji won) that perhaps the drinking wasn't so much about thirst as it was about pica. I don't know if people actually get pica with liquids and I refuse to ask Dr. Google ...so I'll just ask at the prenatal appt on Monday. Anyway. In the meantime? Guard your faucets.

When I first started this blog way back in ..oh ...September (ha!) ...I was mostly confident that I would never have another baby. I was terrified of another miscarriage ...had completely stopped ovulating ..and had a husband that refused to engage in any IVF type activities. More than just feeling infertile, I was deeply unsettled about everything. I always saw myself as spending the majority of my 20's in the peace corps saving the world and instead I found myself approaching my mid-30's living in a somewhat ritzy suburb driving to basketball games with a somewhat fulfilling job and being ...well...ordinary. I had {almost} everything anyone is supposed to want in the world but found myself struggling with wanderlust and needing something more. I didn't know where my life was supposed to go or how to be happy with all of the amazing things that I had. I was paralyzed and decision-less. When I first started reading infertility blogs, a new world opened up to me and I realized that the recurrent losses and pcos were affecting me more than I let on to myself. Shortly after starting to blog and actually acknowledging how desperately I wanted another baby to happen, I made the decision to make an appointment with an RE ....and then ...to tie me over until the appointment ...use some leftover Clomid as a last ditch effort. Lo & behold ...Halloween rolled around and my pee stick had 2 lines. Hmm. Yeah. I really, really wasn't expecting that. More than that ...I had zero expectations that this baby would live to see the second trimester. None. So ...now that I've spent a couple of weeks here in the second trimester with reassuring fetal heart tones and ultrasounds? I'm settled. More so than I have been in a very, very long time. My home feels peaceful. I don't have fantasies about quitting my job and dragging my teenager off to a 3rd world country. I'm okay with paying a ridiculous mortgage. And while I haven't bought a single thing for the baby yet nor started to prepare the nursery in any way ...I'm mostly happy to stay home every night and rub the ever growing baby bump. So ....how do you blog about contentment? I'm not sure. Do I need to?

Then again. I just got an offer to work at a 5 star resort in the Caribbean for $40k more than what I'm currently making plus room and board ...and umm...no taxes. Maybe the wanderlust isn't totally squashed.

Thursday, January 22, 2009

Day 11 of 12

Or ...why I might go insane before tomorrow.

I'm seriously fried ..tired...done...cripsy. Exhausted. With a capital E. Day 11 of 12 in a row without a day off is not my friend. And the idea of doing this 8 or 9 months pregnant? I don't see how there will possibly be a way. I'm almost punch drunk goofy. Since I now pee like ...5 times a night ...the sleep that I do get is not great. And that? Is totally my fault. I think I was massively dehydrated going into this pregnancy and I'm still playing catch up. I'm drinking at least 3 liters of water a day ..and before I was existing solely on diet pepsi. Anyway. If I stop drinking (mostly) by 7 or 8 ..I sleep all night. But I never stop. I even drink when I get up to pee in the night.

Saturday was a really bad day. I was irritated about having to go into the hospital ...woke up ..got ready ...checked my census ..they're were 7 new patients already ...went to start my car. Umm..nope. Wouldn't start. Got mad. Tried to start Monk's car. Nope ..wouldn't start. Tried to open the garage door to find a neighbor ...nope ..wouldn't open. Umm... Michigan is cold right now. So anyway ...we got a jump from a neighbor ..I took monk's SUV ....spent the Day at the hospital ..came home around 8 at night after I slid into a ditch and promptly locked Monk's only set of car keys in the car which I discovered early on Sunday morning going back to the hospital. Yeah. Umm....Those were kind of the highlights of the day.

Everything else is pretty much quiet. I'm settling into the idea that this baby might live. He/she moves several times a day that I can feel. My next OB visit is on Monday and then we'll schedule the anatomy scan. I'm definitely starting to show. Yikes. I bought some maternity clothes but they are definitely still WAY too big ...so I'm in limbo there ...I'm down to about 3 pairs of pants that actually still fit and are comfortable.

I didn't do ICLW this month because I know that I'm going to be way too busy. And I've been awful about commenting on every one's blogs ....just know that I'm reading ...and following ...just silent. I've been seriously contemplating closing down the blog ...because I don't know...I don't feel like I need it anymore or something? We'll see. I make no decisions when I'm punch drunk with sleep deprivation.

Friday, January 16, 2009

Attachments & Heels

A very long time ago, when I was pregnant with the golden child, I discovered the attachment parenting phenomenon. I bought a couple of books by Dr. Sears and cozied myself right in. I did cloth diapers, the sling, nursing on demand, the family bed. All of it. Hook, line, and sinker. And I have to say that I do think it was a tremendous success. I was a stay at home mom and it made perfect sense. So here I sit ...13 years later, and I feel like a total heel. I don't know exactly what's up with me, but I used to love to cuddle and be close and be loved up. I was always the chaser in the relationship between Monk and I. Nearly begging to cuddle, "Hold me?" was something he heard on a nearly hourly basis. I think I mostly drove him insane. I have felt strictly hands off for the last 2 years at least - with both Monk and the extremely attached one. I'm not sure what it is ...but I'm pretty sure I could nearly poke my eyes out when I come home from work, wanting to relax for a minute, and Monk plants himself on his knees directly in front of me and becomes a close talker 2 inches from my face and wants to just lay on me or something and then the attached one slips into the chair half on me and they both just ....suffocate me. I bear it for as long as I can stand it and then I usually have a big freakout and am mean and yell that I need my space and they back 3 feet away for like ..20 minutes ...and the whole process starts again. I dread coming home because of it, even. I've tried forcing myself through it ...grab on to them both ...cuddle them for like 15 minutes a piece when I get home and hope for the best ...but they seem to be insatiable. At least by me. And it makes me sad ...because the old me? Would love it. The old me? Trained them both to love it. And what if I'm still like this when the next baby is born? How could I not snuggle a newborn? I don't know what happened to me.

The attached one seems also to be going through some minor sort of weird regression right now which I have to believe is somehow related to the baby or her fear about starting high school next year...because it hasn't happened since she was like 5. Aside from the aforementioned snuggle fest, she's become uncharacteristically needy. She follows me from room to room to the point that I went upstairs to change into my pj's and she came running up the stairs behind me and actually screamed, "MOMMY! Wait for me!!" frantically because she didn't want me to ....I don't know ...lock myself in my room without her or something. She hasn't called me mommy in years. I explained that I was changing and would join her in a sec, and when I opened the door to my bedroom she was sitting on the floor outside of it waiting for me. WTF? Seriously. The old part of me buried somewhere recognizes that 1) she obviously needs something more than what she's getting from me right now 2) they're aren't many moms that have a 13 year old that still wants to cuddle and 3) even my attached one won't necessarily want to cuddle with me for very much longer and I shouldn't take it for granted much less reject it.

In completely unrelated and random news:
  • I essentially do a prenatal visit on myself every week when I'm at the family practice clinic - because I'm that insane. Weigh myself, check my urine, my blood pressure, measure my fundal height, and doppler myself. I spent about 15 minutes with the doppler today before I found a strong heartbeat at 160 ...but I almost stroked from minute 5- 15. I considered running to the other wing of the office with my pants around my ankles to get a doc to look about 27 times. I'm fairly certain this child will have anxiety disorder or something. Good god. Please keep in mind that I felt the baby move not more than an hour before I was looking but was still completely convinced it was dead when I couldn't find the heartbeat. I'll never be not crazy, I swear. I will say that I still feel not pregnant. I forget about it for almost an entire day at a time. Even the movement which I feel on a fairly regular basis now I could pass off as something else. I develop more compassion for those weirdos that deliver without knowing they were ever pregnant all the time. I will say that I have developed a tiny bit of attachment to the monster in my stomach - that Monk refers to as "Emmet" - (a story for another day). When I finally found the heartbeat today ....it was the first time I actually felt something close to love and not fear for this pregnancy.
  • I'm on call this weekend. Again. And I hate it more than close to anything else in life. My work week this week will be 90 hours long. I'll work at least 140 hours in a 12 day stretch without a day off. That's not healthy when you aren't pregnant. My problem is that I committed to all of these speaking engagements and what-not before the baby and now it's time to pay the piper, so to speak. Bad timing on my part.

Friday, January 9, 2009

I worked at the family practice clinic on Friday. Things went mostly well. I had a patient come in and they always print the reason for the visit on my schedule. It said "possible pregnancy". It always astounds me that some women still don't use HPT's ..but whatever. She was, in fact, pregnant. But, as it turns out ...she was around 25 weeks with her 3rd baby and just showed up for the first time. She could feel/see the baby move but still chose to pretend that she wasn't pregnant. I became ...irrationally angry. I held it together for the visit and took the opportunity to educate ..but I was livid. The carelessness is something that I cannot even begin to fathom. It makes me ache for those of you still enduring the painful, painful struggle of infertility. I still haven't figured out how to deal with that professionally. I don't know if I ever will. I spent the rest of the day feeling mostly bitter and angry and incredibly jaded.

For some reason, it made me flash back to a patient I had when I was still an ICU nurse. She came in 7 1/2 months pregnant and got instantly very sick. They must have diagnosed her with 100 different rare pregnancy disorders before she finally underwent an emergency section because she was fairly near death. The baby was beautiful and healthy - though tiny. The mom continued to get worse and they couldn't figure out why. It was like an episode of House. They would bring the baby into the ICU to visit her ...and I would hold the baby next to her because she was too weak to hold her. They finally took her for an exploratory surgery and found that she was full of cancer. Everywhere. She died a day later. It broke my heart. It was one of the hardest experiences that I ever had as a nurse. The baby's father left the baby at the hospital and never came back for her. He was beyond broken. We kept her in the special care nursery for weeks beyond when she needed to be there for health reasons - sure that he would come back when his mind settled. He never did. I actually applied to foster the baby and bring her home but couldn't get approved in time. I never found out where the baby ended up.

At the end of the day today, a patient that I hadn't seen in about 3 months came in. She had been trying to get pregnant for over a year with no success. She was, sadly, getting no help from the physician. I took her on as a special project because I was concerned about her being off of a life saving medication to attempt pregnancy for that long and getting nowhere. We did a lot of testing and some starter meds. She came in, crying, to tell me that she was pregnant. I honestly think I felt at least as much joy for her as I did when I got my own positive this time. There is little that has been more rewarding to me.

I'm not sure why these stories are connected for me ....but they are. Closing in on week 15 with everything apparently going well with this pregnancy is bringing me to the realization that this baby may actually live. Listening to the heart rate today was the first time I didn't feel anxiety when touching a doppler. The baby moved so strongly today for such a continuous time that it was actually distracting for a few seconds during a patient visit. I'm thinking about my career and what it's going to be as a mom to a newborn. I hate change. Hate it. But when I was pregnant for the golden child, I never hesitated for a second at dropping out of med school. I knew I needed more time with the baby than med school or being a physician would ever allow. I'm sensing a career change for me around the corner ....and maybe a drastic one. The passion that I feel about infertility and pregnancy and pregnancy loss is intense. I have to believe there is a place and a way for me to put that to good use. It's just a matter of finding where and when.

Sunday, January 4, 2009

Living la vida teenager

I've been nearly ready to kill the golden child for the past week. She might have to have a new blog name - because she is not being golden. Her infractions are, in the grand scheme of things, incredibly minor. What distresses me, however, is her lack of remorse for the infraction to begin with. As an example, she's had braces for about a half of a year. $6,000 worth of braces and they need to be on for another year. Her teeth were awful. About two weeks after the braces went on? The two most horrendous teeth magically dropped into perfect position. I would have taken them off right then if I could have gotten some of the money back ...but no. So anyway. I'm fairly strict about the braces rules, because, in my world, six grand is a lot of moula. One thing that is absolutely forbidden is popcorn. She's been swearing that she hasn't had any. She had a friend over and it came out somehow that she has it all the time. I almost twisted her ears, I swear. Not really. But I wanted to. Then I caught her lying about a new t-shirt that she had on. I asked her where she got it ...she said, "So and so friend gave it to me for Christmas." That same night? Her friend said something which clearly meant that the golden child had bought it for herself. And umm....I really couldn't have cared less if she bought herself a shirt. She babysits. She makes her own money. So why the lie? I have no idea. But it concerns me. And she thinks it is funny. So ...I'm struggling with how best to handle it right now. I'm feeling the urge to lock her in the basement and tie her up with chains instead of letting her go to high school next year because of what could be around the corner. I don't really want to over react but I do want her to get the impression that I'm serious and don't like being lied to. In my mind right now lying about popcorn means she might be shooting up heroin in the next year or so ...and while logically I know that's not rationale, emotionally convincing myself of that is something else altogether.

As for pregnancy ...umm...I don't so much feel pregnant. Bizarre. Now that the wretched morning sickness is all but gone and I don't feel like passing out if I walk more than 10 steps, I can actually see how women would not know they were pregnant. Cause without the beta hcg's that I was compulsive about ordering for myself? I could totally assume it was just lymphoma or a prolonged viral illness or something. With every pregnancy before this, I've been totally focused on the baby. My general train of thought would be something like "Hmm...to do(baby) list for today (I'm pregnant!!)...I need to go renew my license (baby) buy some (MY baby)" blah blah. This time around, I feel like I'm following another infertile bloggers pregnancy. Very detached and distant. Happy. Amused....but not really my life. Just like I get excited when I check in on Allison and see that she's already 32(!!) weeks pregnant ...I log into my own blog and think "Wow! 14 weeks already? Time flies. That's so cool for her." Umm..okay psycho. It's not "her". It's me. Maybe I'll grow attached at week 15 ...a week I haven't seen in the pregnancy world in 14 years. If not? Someone is going to have to kick me in the assno to get me to get the nursery ready before the nugget is born.

Speaking of the nursery ...because I want this to be the longest post ever ...when we bought this house 2 1/2 years ago before the hell of recurrent loss, one of my favorite things (after the white picket fence) about the house was the ready made nursery. It was, essentially, perfect for me. Gender neutral ..inspired by pottery barn...I wouldn't have needed to change a thing. After the 1st miscarriage ....we threw all sorts of extra stuff in the room ..filled it from top to bottom and called it the "crap" room instead of the "nursery". After the 2nd loss, when we thought we had things figured out and the next baby would live ...we cleaned it out again. After the third loss? I closed the door to the room and refused to talk about it. I came home from work one day and Monk had painted the entire room adobe brown, moved in a dresser, and a queen sized bed and it became the guest room. So umm....at some point and time? We'll have to work on a nursery again. People wonder why I'm crazy.